Child and Adolescent Psychiatric Clinics of North America
Epidemiologic Considerations in Attention Deficit Hyperactivity Disorder: A Review and Update
Section snippets
Methodological aspects of surveys
To generate meaningful and valid prevalence estimates, epidemiologic surveys must address a host of methodological strategies. In addition, for ADHD studies, several specific methodological choices may result in different prevalence estimates [4]. Thus, different prevalence estimates are generated depending on the specific diagnostic criteria and system applied, informant source and strategies used to collect and combine diagnostic information, and whether and how the criterion of impairment is
Prevalence in childhood and adolescence
Given the growing interest and recognition of ADHD, its prevalence has been frequently studied in the past decade, with surveys conducted with different methodological approaches and in diverse cultures. Several reviews [11], [15], [16], [17], [18], [19], [20] have summarized this literature, including three systematic reviews that made rigorous efforts to ensure the unbiased selection of studies [4], [21], [22]. The most recent of these comprehensive systematic literature reviews [4] examined
Prevalence in adulthood
Longitudinal studies have consistently shown that ADHD symptoms tend to decline over time, but a considerable number of affected subjects remain symptomatic and impaired in adulthood, even if the full syndrome has remitted [90], [91]. Only recently has ADHD became a major focus of clinical attention [92] in studies of adults and among adult-oriented practitioners. Nevertheless, full agreement has not been reached on the phenomenology and diagnostic criteria of the disorder [93], [94], which
Demographic and psychosocial correlates
The most consistently reported demographic factor characterizing ADHD samples across epidemiologic studies is the higher rates of ADHD among men than among women. Table 2 shows the typical higher prevalence rates for men over women, averaging 11.3% and 5.4%, respectively (approximately a 2.4:1 ratio). Replicating the overall results from Table 2, an analysis of the 2003 National Survey of Children's Health (NSCH), which screened 102,353 children, showed that the diagnosis of ADHD was 2.5 times
Summary
This article reviews the major issues in the epidemiology of ADHD. ADHD surveys published in the past 10 years were selected based on a systematic search strategy. The review included 71 studies and the estimates reported showed an important variability. Findings are consistent with previous reports showing that the variability among prevalence estimates of childhood ADHD is related to methods used within specific surveys [4]. These findings indicate that the methodology of a given survey must
Acknowledgments
The authors thank Luis Augusto Rohde for his helpful suggestions on this article.
References (105)
- et al.
10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden
J Am Acad Child Adolesc Psychiatry
(2005) - et al.
Attention-deficit hyperactivity disorder: a category or a continuum? Genetic analysis of a large-scale twin study
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
ADHD in a school sample of Brazilian adolescents: a study of prevalence, comorbid conditions, and impairments
J Am Acad Child Adolesc Psychiatry
(1999) Child psychiatric disorders: prevalence and perspectives
Psychiatr Clin North Am
(1985)- et al.
Epidemiology of ADHD in school-age children
Child Adolesc Psychiatr Clin N Am
(2000) - et al.
Parent and child contributions to diagnosis of mental disorder: are both informants always necessary?
J Am Acad Child Adolesc Psychiatry
(1999) - et al.
Factor structure and cultural factors of disruptive behaviour disorders symptoms in Italian children
Eur Psychiatry
(2006) The epidemiology of attention-deficit hyperactivity disorders
Child Adolesc Psychiatr Clin N Am
(1992)- et al.
Attention-deficit hyperactivity disorder
Lancet
(2005) - et al.
Attention-deficit hyperactivity disorder and hyperkinetic disorder
Lancet
(1998)
Gender differences in children with ADHD, ODD, and co-occurring ADHD/ODD identified in a school population
J Am Acad Child Adolesc Psychiatry
Mental health problems among schoolchildren in United Arab Emirates: prevalence and risk factors
J Am Acad Child Adolesc Psychiatry
Prevalence of child and adolescent psychiatric disorders in southeast Brazil
J Am Acad Child Adolesc Psychiatry
The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders
J Am Acad Child Adolesc Psychiatry
Comparison of attention-deficit/hyperactivity disorder symptom subtypes in Ukrainian schoolchildren
J Am Acad Child Adolesc Psychiatry
Validity of DSM-IVADHD subtypes in a nationally representative sample of Australian children and adolescents
J Am Acad Child Adolesc Psychiatry
Child psychiatric diagnoses in a population of Dutch schoolchildren aged 6 to 8 years
J Am Acad Child Adolesc Psychiatry
Challenging times: prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents
J Adolesc
Teacher reports of ADHD symptoms in Italian children at the end of first grade
Eur Psychiatry
Psychiatric disorders among Japanese children
J Am Acad Child Adolesc Psychiatry
Association of attention-deficit/hyperactivity disorder symptoms with levels of cigarette smoking in a community sample of adolescents
J Am Acad Child Adolesc Psychiatry
Voice-DISC identified DSM-IV disorders among 15-year-olds in the west of Scotland
J Am Acad Child Adolesc Psychiatry
Psychosocial and clinical correlates of ADHD in a community sample of school-age children
J Am Acad Child Adolesc Psychiatry
Interacting effects of the dopamine transporter gene and psychosocial adversity on attention-deficit/hyperactivity disorder symptoms among 15-year-olds from a high-risk community sample
Arch Gen Psychiatry
Catechol O-methyltransferase gene variant and birth weight predict early-onset antisocial behavior in children with attention-deficit/hyperactivity disorder
Arch Gen Psychiatry
The worldwide prevalence of ADHD: a systematic review and metaregression analysis
Am J Psychiatry
Quebec child mental health survey: prevalence of DSM-III-R mental health disorders
J Child Psychol Psychiatry
The ICD-10 classification of mental and behavioral disorders: diagnostic criteria for research
Diagnostic and statistical manual of mental disorders
The DSM-IV rates of child and adolescent disorders in Puerto Rico: prevalence, correlates, service use, and the effects of impairment
Arch Gen Psychiatry
Epidemiology of attention-deficit/hyperactivity disorder across the lifespan
Curr Opin Psychiatry
Attention-deficit hyperactivity disorder in girls: epidemiology and management
CNS Drugs
The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view
Ment Retard Dev Disabil Res Rev
The worldwide prevalence of ADHD: is it an American condition?
World Psychiatry
Variations in prevalence of attention deficit hyperactivity disorder worldwide
Eur J Pediatr
Psychiatric disorders in 8-9-year-old children based on a diagnostic interview with the parents
Eur Child Adolesc Psychiatry
Psychiatric disorder, impairment, and service use in rural African American and white youth
Arch Gen Psychiatry
Prevalence of mental and behavioural disorders in Ethiopian children
East Afr Med J
The prevalence of ADHD among primary school children in an Arabian society
J Atten Disord
Prevalence and clinical characteristics of attention deficit hyperactivity disorder among primary school students in Bangkok
J Med Assoc Thai
Use of complementary and alternative medicine for symptoms of attention-deficit hyperactivity disorder
Psychiatr Serv
Estimation of the prevalence of attention deficit hyperactivity disorder among the standard population on the island of Majorca
Rev Neurol
Prevalence of attention deficit hyperactivity disorder in Colombian children and teenagers
Rev Neurol
Children with psychiatric disorders: the A1 Ain Community Psychiatric Survey
Can J Psychiatry
The distribution of symptoms of attention-deficit/hyperactivity disorder and oppositional defiant disorder in school age children in Turkey
Eur Child Adolesc Psychiatry
Frequency, comorbidity and psychosocial correlates of attention-deficit/hyperactivity disorder. Results of a Bremen adolescent study
Fortschr Neurol Psychiatr
ADHD prevalence in four Brazilian public schools
Arq Neuropsiquiatr
A 3-year panel study of mental disorders among adolescents in Taiwan
Am J Psychiatry
Behavioral characteristics of DSM-IV ADHD subtypes in a school-based population
J Abnorm Child Psychol
DSM-IV AD/HD: confirmatory factor models, prevalence, and gender and age differences based on parent and teacher ratings of Australian primary school children
J Child Psychol Psychiatry
Cited by (0)
Funding sources: This work was supported by a research grant from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil) (Grant MCT/CNPq 02/2006 - Universal). Dr. Polanczyk holds a doctoral fellowship, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Ministry of Education, Brazil.
Conflict of interest: Dr. Jensen currently receives investigator-initiated grants from Ortho-McNeil Pharmaceutical, Inc. and unrestricted educational grants from Pfizer Inc., Eli Lilly and Company, and Ortho-McNeil Pharmaceutical, Inc.; participates in speakers' bureaus for UCB Pharma, psychCME, CME Outfitters, and the Neuroscience Education Institute; and consults with Best Practice, Inc., Janssen Pharmaceutica, Inc., Novartis, and UCB Pharma. Dr. Polanczyk has no conflict of interest to declare.